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Preferred Name (if different from First)

Last Name

Birthdate

Email Address

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Home Phone

Mailing Address (for materials to be sent to your address)

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Which best describes your student status:

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What semester do you plan to enroll?

What are your academic interests? Select all that apply

Are you interested in this program on-campus or online/virtual?

Online: Online courses have no face-to-face component. Some courses may require proctored exams.
Virtual: Asynchronous and synchronous learning; a student will not only work on their own schedule to meet deadlines for assignments but also will attend scheduled virtual class sessions.

Please select the sport(s) you plan to play in college

Do you plan to participate in any of these areas?

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